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Volume 41, Issue 8
Displaying 1-12 of 12 articles from this issue
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Yoh Miyashita, Kohji Shirai, Shoichiro Hashiguti, Mitsuya Totsuka, Yos ...1998 Volume 41 Issue 8 Pages 655-661
Published: August 30, 1998
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSThe midband detected by polyacrylamide gel (PAG) disc electrophoresis is known to be an atherogenetic lipoprotein, and is observed frequently in patients with non-insulin dependent diabetes mellitus (NIDDM). We determined the effect of an α-glucosidase inhibitor, acarbose, on the midband in patients with NIDDM. Acarbose (300mg/day) was administered for 4 months to 55 patients with NIDDM. Body weight, HbAic, total cholesterol (TC), triglyceride (TG), high densitylipoprotein cholesterol (HDL-C) and the midband were measured monthly. The midband was detected by PAG disc electrophoresis. After administration of acarbose for 2 months, HbA1c, TC and TG were decreased significantly (p<0.01) without a loss in weight. The ratio of patients with a decrease in the midband was 45% of all patients after acarbose administration for 4 months. The mean midband score, which was determined by semi-quantitative analysis, decreased with time significantly. These results suggest that acarbose decreased the midband as well as the mean blood glucose levels in patients with NIDDM.View full abstractDownload PDF (943K) -
Nobuhiro Tsujimoto, Masao Kanauchi, Tamio Nakajima, Hiroki Ozaki, Taiz ...1998 Volume 41 Issue 8 Pages 663-668
Published: August 30, 1998
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSWe determined insulin resistance using the euglycemic glucose-clamp technique in 40 patients with ischemic heart disease who underwent coronary angiography in our clinic between March 1996 and March 1997. We evaluated the severity of coronary artery lesions based on the number of damaged vessels, types of stenosis of the coronary artery, and presence of calcification in the coronary artery. The stenosis shape was divided into three types by using the classification of the American Heart Association (1993):(Type A, less than 10 mm, simple; type B, 10-20mm, moderate; type C, longer than 20 mm, severe, diffuse, complicated). The average glucose infusion rate (mean glucose infusion rate, M-value) in patients with two-or three-vessel disease was significantly less than that in patients with one-vessel disease, and the M-value was lower in patients with type B or C lesions than in those with type A lesions. In addition, the M-value in patients with calcification of the coronary artery was lower than that in patients without calcification, but this difference was not significant. These findings suggest that insulin resistance is related to the development of ischemic heart disease.View full abstractDownload PDF (947K) -
Fukashi Ishibashi1998 Volume 41 Issue 8 Pages 669-675
Published: August 30, 1998
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSSerum and urinary TGF-β1 levels were determined by ELISA before and after L-arginine in, ion (LA), which inhibits tubular reabsorption o, roteins, in 49 NIDDM patients with, DDM-II, N=23) or without microalbuminuria (MAU), DDM-I, N=26) and in healthy controls (N=35) to elucidate the pathogenetic role of TGF-β1 in the development of MAU. Serum or urinary TGF-β1 was significantly correlated with FPG (r=0.22-0.49) and HbA1c (r=0.36-0.51). Serum TGF-β1 in the, NIDDM groups was sli, ly, in part significantly, higher than in the control group. LA increased urinar, GF-β1 in all groups, and that in NIDDM-II (0.46±0.06→1.30±, 0ng/hr) was the highest, and that in NIDDM-I (0.37±0.04→0.91±0.05ng/hr) was higher than in the controls (0.19±0.02→0.66±0.05ng/hr), n the group as a whole, urinary TGF-β1 before and after LA was correlated with the AER (r=0.26 vs r=0.63) and glomerular filtr, on of albumin (r=0.36 vs r=0.59), and inversely correlated with the rate of tubular album, reabsorption (r=0.37 vs r=0.49), the stronger correlation being, nd after LA. On the other hand, serum TGF-β1 was not significantly correlated with either of them (r=0.13-0.02). Thes, esults indicate that urinary TGF-β, 1, exaggeratedly produced by hyperglycemia, plays a permissive role in the development of MAU in NIDDM.View full abstractDownload PDF (1187K) -
Keiichiro Ogoshi, Toshihiko Miyahara, Shujiro Koyanagi, Yosikatu Migit ...1998 Volume 41 Issue 8 Pages 677-682
Published: August 30, 1998
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSWe investigated the pancreatic endocrine function, exocrine function and insulin resistance in patients with pancreatic mucin-producing tumors (MPT)(n=16). Ten of 16 patients (63%) had impaired glucose tolerance. In histological findings, patients with adenocarcinoma had diabetes mellitus. This observation showed that glucose tolerance tended to be more disturbed in patients with adenocarcinoma than in patients with adenoma. There was no significant difference in pancreatic exocrine function between the groups with and without impaired glucose tolerance. The urinary C-peptide output and the results of the glucagon test indicated that insulin secretion was conserved in almost cases. In the arginine tolerance test, 4 patients with impaired glucose tolerance had a normal glucagon secretory response. The glucose infusion rate (GIR) was determined by the euglycemic hyperinsulinemic clamp technique to evaluate the insulin resistance in 3 MPT patients with impaired glucose tolerance. All 3 patients showed marked insulin resistance. We concluded that impaired glucose tolerance associated with MPT was caused by not only the reduction of insulin secretion but also insulin resistance.View full abstractDownload PDF (917K) -
Minoru Inoue, Tutomu Satou, Taeko Shimizu, Kanemi Tumagari, Hirotaka I ...1998 Volume 41 Issue 8 Pages 683-690
Published: August 30, 1998
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSThe effect of long term therapy over 6 months in type II diabetic patients with secondary failure using surfonylureas was evaluated by comparing morning NPH insulin alone (mono-therapy group)(n=19) with surfonylureas plusα-glucosidase plus bedtime NPH insulin (combination therapy group)(n=17). Glycemic control improved in both groups ; however, there was no difference in HbAic level between the two groups (7.7±1.2% in the mono-therapy group vs. 7.2±0.8% in the combination therapy group).
Six months after discharge, total insulin dosage was significantly less in the combination therapy group compared with the mono-therapy group (5.2±2.4U vs. 21.1±4.9U, p<0.01). At the same time, weight gain was also suppressed more significantly in the combination therapy group than in the mono-therapy group.(0.5±2.2 kg vs. 2.5±3.0 kg, p<0.01).
Combination therapy was effective in achieving a normal FPG level without causing excessive or severe hypo-glycemia and could achieve similar glycemic control without weight gain, with smaller doses of insulin than with mono-therapy.
We conclude that combination therapy merits consideration as a therapeutic strategy in patients with secondary failure using sulfonylureas.View full abstractDownload PDF (1223K) -
Keiji Kubo1998 Volume 41 Issue 8 Pages 691-697
Published: August 30, 1998
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSThe effects of troglitazone on abnormalities of the blood coagulation-fibrinolytic system were investigated in obese NIDDM patients. The subjects were 21 NIDDM patients, 14 of whom were administered troglitazone [BMI: 26.5±3.5kg/m2 (mean±SD)] and 7 of whom received gliclazide for 12 weeks. Fasting blood samples were collected before and after administration, and the levels of plasma glucose (FPG), HbAic, insulin (IRI), C-peptide (CPR), plasminogen activator inhibitor l (PAI-1) and fibrinogerl were measured. After toglitazone administration, FPG arld HbA1c showed a significant decrease, and IRI and CPR also declined significantly. Futheremore, PAI-1 (132.4± 62.1→71.8±29.9ng/ml) and fibrinogen (297.9±55.7→250.0±41.4mg/dl) decreased significantly (p<0.01). After gliclazide administration, FPG and HbAic showed similar reductions as in the group given troglitazone. However, PAI-1 (79.9±32.2→71.0±21.7ng/ml) and fibrinogen (270.3±21.3→286.1±60.8mg/dl) showed no changes after gliclazide administration, and IRI and CPR also showed no change. In obese NIDDM patients, it appears that administration of troglitazone might improve abnormalities of the coagulation-fibrinolytic system in addition to improved glycemic control and a decrease of hyperinsulinemia.View full abstractDownload PDF (1044K) -
Hiroaki Seino, Akiyo Karita, Nobuko Arawaka, Toshio Yamazaki, Hiroaki ...1998 Volume 41 Issue 8 Pages 699-704
Published: August 30, 1998
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSWe have found leukocytosis in serum of two patients with diabetic ketoasidosis without compli cationby definite infection. In case 1, a 17-year-old boy was admitted to our hospital because of diabetic ketoacidosis. Laboratory findings revealed a plasma glucose level of 1, 053mg/dl, a pH of 7.125 and a WBC count of 16, 900/mm3. In Case 2, a 29-year-old man was admitted because of diabetic ketoacidosis, and laboratory findings revealed a plasma glucose level of 739mg/dl, a pH of 7.190 and a WBC count of 16, 200/mm3. In both cases, the CRP level was below 0.5.
We measured the serum levels of cytokines IL-8, IL-1βand GM-CSF in these two cases by ELISA. Only IL-8 was detected in the serum of both patients. The levels were 546pg/ml in case 1 and 64pg/ml in case 2. After recovery from diabetic ketoacidosis and normalization of plasma glucose levels, the IL-8 level in these two patients was below the detection limit of 20pg/ml.
Serum IL-8 in patients with diabetic ketoacidosis may induce leukocytosis. According to our knowledge, this is the first report of detection of IL-8 in the serum of patients with diabetic ketoacidosis.View full abstractDownload PDF (832K) -
Mitsuo Tashiro, Yoshimitsu Ogami, Hiroyuki Yoshikawa, Yasuyuki Kihara, ...1998 Volume 41 Issue 8 Pages 705-709
Published: August 30, 1998
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSWe report a case of insulin autoimune syndrome (IAS) repeatedly induced by thiamazole (MMI). A 26-year-old man was referred to our hospital because of hypoglycemia in 1994. He was found to have hyperthyroidism at his first clinic visit in 1988. In 1991, he was prescribed thiamazole at another clinic. Three weeks later, he had a hypoglycemic attack. After changing MMI to propylth iouracil (PTU), he had no more hypoglycemic attacks. In 1994, he came for his third-clinic visit and received MMI again. Four weeks later, he had a hypoglycemic attack again. On his fourth visit, he was admitted to the fourth hospital because of the hypoglycemic attack. In the hospital, he was medicated with MMI continuously, and he had a hypoglycemic attack yet again. He was transfered to our hospital to examine the causes of hypoglycemia. Detailed past history of the present illness revealed that the present case is IAS repeatedly induced by MMI.View full abstractDownload PDF (772K) -
Yuzuru Ohshiro, Ichiro Komiya, Nobuyuki Takasu, Naoya Taira, Akihiro K ...1998 Volume 41 Issue 8 Pages 711-716
Published: August 30, 1998
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSWe observed changes in the secretion of insulin in a 47-year-old male during treatment for severe alcoholic ketoacidosis (AKA). Prior to admission, he had ingested 1.8 liters of strong liquor (ethanol 540g) daily for three days. He experienced severe vomiting and was taken to our hospital. On admission, he showed severe acidosis (pH=6.89), which was successfully treated with a drip infusion of dextrose. Although the serum glucose level remained high (300mg/dl), the patient initially had a delayed and relative low level of insulin secretion. Insulin secretion eventually normalized because his serum insulin level reached 120, μU/ml during glucose-challenge testing using 75g OGTT on admission day 5. Although relative insulin deficiency is believed to be most important for the pathogenesis of AKA, there are few reports which document this. We report a case of a patient who showed decreased insulin secretion associated with AKA.View full abstractDownload PDF (916K) -
Masayuki Noritake, Yoshiya Katsura, Toshiya Watanabe, Satoshi Koshikaw ...1998 Volume 41 Issue 8 Pages 717-720
Published: August 30, 1998
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSSince elevation of plasma serotonin and enhanced platelet aggregation in response to serotonin have been reported in patients with diabetes, it is possible that serotonin has a role in the path ogenesisof the peripheral micro-circulation in diabetic patients. To clarify the acute effect of a selective S 2-serotonergic receptor antagonist, sarpogrelate, on insulin sensitivity in patients with NIDDM, insulin sensitivity tests were performed. Insulin, glucose and Sandostatin (Sandoz, Basel, Switzerland) were infused intravenously for 240 minutes. Just after the determination of steady state plasma glucose (SSPG) at 120 minutes, sarpogrelate was administrated orally, and blood samples were obtained every 60 minutes for 240 minutes in order to measure insulin, C-peptide reactant and glucose levels. SSPG of the patients (n=11) was 227±17mg/dl and plasma glucose levels decreased significantly (p<0.05) after administration of sarpogrelate while plasma glucose levels after 120 minutes in the patients without sarpogrelate administration (n=6) showed no significant changes. We conclude that sarpogrelate significantly increased insulin sensitivity and improved glucose metabolism to some degree in patients with NIDDM.View full abstractDownload PDF (647K) -
1998 Volume 41 Issue 8 Pages 721-735
Published: August 30, 1998
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSDownload PDF (3796K) -
1998 Volume 41 Issue 8 Pages 737-776
Published: August 30, 1998
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSDownload PDF (4844K)
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